Support the Bottom Line — and the Big Picture
Create the financial strategies that affect our patients, medical centers, and future. On this team, you'll provide the strategy recommendations that drive operational and process improvement, as well as face challenging opportunities to influence the future of health care.
Contract Manager, NDPCLocation: Aurora, CO Additional Locations:
Job Number: 819184 Date posted: 08/09/2019
Internal Bidding Period: 08/02/2019 to 08/06/19
Negotiates, implements and maintains contracts with outside providers and vendors in the areas of hospitals, professional, ancillary, skilled nursing facilities, and other technical services that are cost effective and deliver quality services. Primarily responsible for the management of the relationships with key medical groups, hospitals, and ancillary providers as assigned. Maintain and support a
culture of compliance, ethics and integrity. Responsible for ensuring ongoing compliance for External Medical Services. Maintains knowledge of policies and procedures and performs in accordance with applicable regulatory requirements, external laws and accreditation standards as they relate to External Medical Services.
- Negotiates with external providers/vendors for development and implementation of contracts.
- Interacts with internal departments pursuant to contract development/implementation.
- Maintains relations with contract providers.
- Analyzes perspective payment amounts related to offering of new/existing contracts.
- Writes and modifies contractual agreements to match the type of provider/vendor, e.g. hospital , ASC, mental health and/or equipment.
- Resolve incoming escalated provider inquiries related to claims, credentialing, and member complaints.
- Reviews key contract provisions with Medical Group and Health Plan staff and obtains buy-in and approval of key provisions.
- Coordinates implementation/administration of new contracts and coordinates administration of existing contracts; resolves contractual issues.
- Act as a main contact for education as well as a liaison between the provider and the health plan to present, promote, and resolve clinical and administrative concerns of provider.
- Minimum two (2) years of health care experience involving quantitative and financial analysis, negotiating contracts, and health care billing/claims.
- Bachelor's degree in business, health care administration OR four (4) years of experience in a directly related field.
- High School Diploma or General Education Development (GED) required.
License, Certification, Registration
- Working knowledge of budget management, claims processing, medical coding and contract language/reimbursement models.
- Ability to work with computers for data retrieval and design, and use of financial analysis models.
- Highly effective negotiation and written communication skills.
- Experience working with professional providers with negotiation skills.
External hires must pass a background check/drug screen. Qualified applicants with arrest and/or conviction records will be considered for employment in a manner consistent with federal and state laws, as well as applicable local ordinances, including but not limited to the San Francisco and Los Angeles Fair Chance Ordinances.
About Accounting, Finance, & Actuarial Careers
Members of our accounting team support corporate projects and lend insight to areas such as financial reporting, tax planning and preparation, and audit management. This team also includes our audit professionals, who partner with financial and operational groups across the organization to analyze budgets and streamline procedures.
Supporting critical business functions such as financial services, national Medicare finance, strategic planning, auditing, and corporate finance, our finance professionals develop the strategies that enable us to meet our financial goals.
Applying probability and statistics to the practical problems of insurance, our actuarial team performs a variety of duties, including calculating the cost of premiums and policy values, preparing statistical studies, and forecasting financial results.
See What People are Saying About Working at KP
Mar 26, 2019
"The best job I have ever had!"
- Positive Outlook
- Approves of CEO
I have been working at Kaiser Permanente full-time for more than a year
Real focus on creating higher quality, more affordable healthcare. Talented coworkers and great mentors. Fabulous benefits.Full Review
Come introduce yourself to a member of the Kaiser Permanente team at an upcoming career or professional event. We look forward to meeting you in person.
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